Frequently Asked Questions*

I want help, but how much will that cost?

Absolutely nothing. I don't accept payments from clients (in fact, it's illegal for me to do so!). 

Then how do you get paid?

As a broker, my compensation comes from the insurance companies when I help you enroll in one of their plans.

When you enroll in a plan, someone gets paid - whether it is through a call center or directly with an agent or broker (if you enroll online, the insurance company offering the plan still receives payment directly from the federal government for a pre-agreed upon amount per person).

• This is a highly regulated industry, and each company pays the same amount.

• I represent 16 different companies (listed at the bottom of this page), so I am truly autonomous when it comes to advising. I’ve done it this way to provide a wide array of options to ensure a plan fits you - not the other way around.

But you told me I’m good, and I don’t need to make a change - how do I compensate you?

You don’t - and it’s ok! Everything good (and bad) comes back around in life. I’m happy to be of service, and to provide peace of mind.

Remember - I don’t fix what isn’t broken.I appreciate that you reached out, and please call me again with future questions.

Referrals to your friends and family, as well as Google reviews, are incredibly appreciated and the biggest compliments I can receive. (Leave one here!)

When should I enroll in Medicare?

Generally speaking, the answer is the 7-month window of time surrounding your 65th birthday. This is defined as 3 months before the month of your 65th birthday, the month of your 65th birthday, and 3 months after the month of your 65th birthday.

There are also situations when you are able to sign up before turning 65 or you may choose to delay signing up past 65.  If you have any questions, please give me a call to discuss your specific needs.

Sign up for Medicare Parts A and/or B here.

What does Medicare Part A cover, and what does Part B cover?

Part A (Hospital Insurance): Partially covers inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care. Part A is often referred to as hospital insurance.

Part B (Medical Insurance): Helps cover: outpatient care, preventive services, doctor visits, and some home health care. Part B is commonly known as medical insurance.

Should I choose Original Medicare or a Medicare Advantage Plan?

There is no one-size-fits-all solution for Medicare. I encourage scheduling a one-on-one conversation to get some guidance with this question. While tempting, I advise against relying solely on a neighbor, YouTube or TikTok advice, or listening to anyone using extreme terms like 'All,' 'Always,' or 'Never.'

A lot of people have a lot of opinions, but they are not in your situation - and often not in the industry, either. Whether it’s us or another licensed, accredited broker, please speak with someone who a) knows Medicare well and b) will really listen to your situation. This is for your benefit.

What is the difference between Medicare Advantage and Medicare Supplement (Medigap) plans?

While both help cover gaps in Medicare, Medicare supplements (also called Medigap) act as secondary insurance to Part A and Part B. After Medicare pays its portion, the remaining charges go to your supplemental company, which pays based on your plan (Plan F, Plan G, or Plan N).

In contrast, Medicare Advantage (Part C) plans are separate from Medicare. With an Advantage policy, benefits come from the plan, not Medicare. You agree to use the plan's network, except for emergencies, paying copayments as you go. You will still need to continue to pay your part B premium to stay enrolled in a Medicare Advantage (Part C) plan.

How do prescription drug plans (Part D) work, and do I need one?

Medicare Part D, a federal program, is managed by private insurance companies.

• Note: Part D changed significantly in 2025. See current details here: Part D Improvements

You can choose between a stand-alone prescription drug plan or one integrated into a Medicare Advantage plan (MAPD), but not both simultaneously. The best choice depends on your medications and location.

Failing to obtain Part D coverage or having non-creditable coverage may lead to penalties. Even if you're not currently taking prescriptions, enrolling in creditable Part D coverage is advisable to avoid potential penalties.

What are the costs associated with Medicare, including premiums and out-of-pocket expenses?

Medicare expenses are influenced by various factors, including your income from two years ago and premium costs for cost-share and Part D options. While we can provide a close estimate for monthly/yearly costs, the actual figures depend on several variables. Book a consult for a no-cost, no-obligation estimate, tailored to your specific situation.

Can I keep my current doctors and healthcare providers with Medicare?

A top question I often hear is, 'Do I need to switch doctors?' While I can't guarantee coverage for every doctor, as long as your doctor accepts Medicare, there's likely a plan that includes them. 

However - exceptions exist, especially with boutique-style healthcare providers increasingly not accepting Medicare. In such cases, if you choose to see them, you may have to cover their rates without much financial assistance.

How Original Medicare works

What is the "Medicare Annual Enrollment Period", and what can I do during that time?

Medicare health and drug plans can make changes each year (cost, coverage, which providers and pharmacies are in their networks, etc.). The Medicare Annual Enrollment Period is October 15 to December 7 every year, and is the time when those currently on Medicare have the opportunity to change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.

How does Medicare coordinate with other insurance, such as employer-based coverage or Medicaid?

If you have Medicare and other health insurance (like from a group health plan, retiree coverage, or Medicaid), each type of coverage is called a "payer". When there's more than one payer, "coordination of benefits" rules decide who pays first. 

What is the coverage for preventive services under Medicare?

Medicare pays for many preventive services to keep you healthy.

• QUICK TIP: Download the What’s Covered app from CMS (Centers for Medicare and Medicaid Services) and get accurate cost and coverage information right in your hand, directly from the source. Find it on on the App Store and Google Play.

How do Medicare Advantage Plans differ from each other, and how do I choose the right one for me?

This is another one of the top questions I get. Based on your doctors, medications and health needs, we will work together to find the plan that best fits your needs.

Are there any programs or assistance available to help with Medicare costs?

Yes, There are several programs to assist with Medicare costs available to those who qualify:

Get help with costs | Medicare

Medicare and the Oregon Health Plan (OHP)

What happens if I want to change my Medicare plan after the Annual Enrollment Period?

There are two opportunities outside of the Medicare Annual Enrollment Period when you may be able to make changes to your Medicare coverage: 

1. The Medicare Advantage Open Enrollment Period (January 1 - March 31)

2. The Special Enrollment Period (for qualifying life events)

In Oregon we have a special rule called the Birthday Rule. This applies to Medigap (Medicare Supplement) plans only.

What should I do if I'm still working and have employer-sponsored health coverage when I turn 65?

If you are covered under an employer plan, you may want to delay signing up for Part B until you (or your spouse) retire(s). However, it is a good idea to check with Social Security or Medicare to confirm you will not face a penalty for late enrollment.

How do I appeal a Medicare decision if I disagree with it?

If you have a Medicare health plan, start the appeal process through your plan. Follow the directions in the plan's initial denial notice and plan materials. You, your representative, or your doctor must ask for an appeal from your plan within 60 days from the date of the coverage determination.

Which insurance carriers do you represent?

• Aetna

• Aflac

• CareOregon

• Cigna

• Devoted

• Humana

• Kaiser Permanente

• Manhattan Life

• Moda Health**

• PacificSource

• Providence Health Systems

• Regence BlueCross BlueShield of Oregon

• Summit Health**

• United American

• UnitedHealthcare

• Wellcare

This is all very helpful…but I’m still confused. Now what?